Perceptions and experiences related to use of breastmilk from another mother in central Nepal: a qualitative study

Abstract Background When maternal breastmilk is unavailable in sufficient quantity for infant needs, the World Health Organization (WHO) recommends the use of donor breastmilk if safe, affordable, and available. However, in Nepal and most other low- and middle-income countries (LMICs), there are sig...

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Main Authors: Akina Shrestha, Natalie Gulrajani, Amy Sarah Ginsburg, Victoria Laleau, Soujanya Gade, Valerie Flaherman, Mahesh C. Puri, Srijana Dongol
Format: Article
Language:English
Published: BMC 2025-03-01
Series:International Breastfeeding Journal
Online Access:https://doi.org/10.1186/s13006-025-00706-8
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author Akina Shrestha
Natalie Gulrajani
Amy Sarah Ginsburg
Victoria Laleau
Soujanya Gade
Valerie Flaherman
Mahesh C. Puri
Srijana Dongol
author_facet Akina Shrestha
Natalie Gulrajani
Amy Sarah Ginsburg
Victoria Laleau
Soujanya Gade
Valerie Flaherman
Mahesh C. Puri
Srijana Dongol
author_sort Akina Shrestha
collection DOAJ
description Abstract Background When maternal breastmilk is unavailable in sufficient quantity for infant needs, the World Health Organization (WHO) recommends the use of donor breastmilk if safe, affordable, and available. However, in Nepal and most other low- and middle-income countries (LMICs), there are significant barriers to accessing safe and affordable donor breastmilk, including a paucity of milk banks. An in-depth understanding of perceptions and experiences in Nepal related to use of donor breastmilk could inform the development of interventions to address identified barriers. Methods From December 2019 to January 2020, we conducted a qualitative study, including focus group discussions (FGDs) with parents and community health workers (CHW), and key informant interviews (KIIs) with public health stakeholders in Dhulikhel municipality, Kavrepalanchowk district in Nepal. In total, 44 individuals participated in five FGDs, including two with mothers, one with fathers, and two with CHW. Nine KIIs were conducted with stakeholders. Thematic analyses of translated transcripts were undertaken to explore perceptions and experiences of participants related to use of human donor breastmilk. Results Participants in this study reported that informal breastmilk sharing between relatives and neighbors is common when a mothers’ breastmilk is unavailable or insufficient and such sharing can occur via direct breastfeeding or milk expression. Numerous potential benefits with breastmilk sharing were described, including overcoming initial difficulties with milk supply in the postpartum period, convenience when mothers are unavailable, and reduced risk of infant infection and gastrointestinal distress. Hesitancies to breastmilk sharing included the risk of disease transmission from donor to infant and the possibility of decreased bonding between mother and infant. Some participants stated that animal milk is preferable to breastmilk sharing when mothers own milk is not available. Conclusion Participants were aware of the potential benefits of donor breastmilk but identified numerous barriers to widespread adoption, including concerns about infectious diseases and mother-infant bonding, and preference for animal milks over another mother’s milk. Addressing these concerns may help increase the acceptance and practice of donating and using donor breastmilk among mothers in Nepal.
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institution Kabale University
issn 1746-4358
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series International Breastfeeding Journal
spelling doaj-art-52182dab411e429dade8ba88dfcfc7812025-08-20T03:41:40ZengBMCInternational Breastfeeding Journal1746-43582025-03-0120111010.1186/s13006-025-00706-8Perceptions and experiences related to use of breastmilk from another mother in central Nepal: a qualitative studyAkina Shrestha0Natalie Gulrajani1Amy Sarah Ginsburg2Victoria Laleau3Soujanya Gade4Valerie Flaherman5Mahesh C. Puri6Srijana Dongol7Department of Public Health, Kathmandu University School of Medical SciencesSchool of Medicine, University of CaliforniaClinical Trials Center, University of WashingtonSchool of Medicine, University of CaliforniaSchool of Medicine, University of CaliforniaSchool of Medicine, University of CaliforniaCenter for Research on Environment Health and Population Activities (CREHPA)Department of Pediatrics, Kathmandu University School of Medical ScienceAbstract Background When maternal breastmilk is unavailable in sufficient quantity for infant needs, the World Health Organization (WHO) recommends the use of donor breastmilk if safe, affordable, and available. However, in Nepal and most other low- and middle-income countries (LMICs), there are significant barriers to accessing safe and affordable donor breastmilk, including a paucity of milk banks. An in-depth understanding of perceptions and experiences in Nepal related to use of donor breastmilk could inform the development of interventions to address identified barriers. Methods From December 2019 to January 2020, we conducted a qualitative study, including focus group discussions (FGDs) with parents and community health workers (CHW), and key informant interviews (KIIs) with public health stakeholders in Dhulikhel municipality, Kavrepalanchowk district in Nepal. In total, 44 individuals participated in five FGDs, including two with mothers, one with fathers, and two with CHW. Nine KIIs were conducted with stakeholders. Thematic analyses of translated transcripts were undertaken to explore perceptions and experiences of participants related to use of human donor breastmilk. Results Participants in this study reported that informal breastmilk sharing between relatives and neighbors is common when a mothers’ breastmilk is unavailable or insufficient and such sharing can occur via direct breastfeeding or milk expression. Numerous potential benefits with breastmilk sharing were described, including overcoming initial difficulties with milk supply in the postpartum period, convenience when mothers are unavailable, and reduced risk of infant infection and gastrointestinal distress. Hesitancies to breastmilk sharing included the risk of disease transmission from donor to infant and the possibility of decreased bonding between mother and infant. Some participants stated that animal milk is preferable to breastmilk sharing when mothers own milk is not available. Conclusion Participants were aware of the potential benefits of donor breastmilk but identified numerous barriers to widespread adoption, including concerns about infectious diseases and mother-infant bonding, and preference for animal milks over another mother’s milk. Addressing these concerns may help increase the acceptance and practice of donating and using donor breastmilk among mothers in Nepal.https://doi.org/10.1186/s13006-025-00706-8
spellingShingle Akina Shrestha
Natalie Gulrajani
Amy Sarah Ginsburg
Victoria Laleau
Soujanya Gade
Valerie Flaherman
Mahesh C. Puri
Srijana Dongol
Perceptions and experiences related to use of breastmilk from another mother in central Nepal: a qualitative study
International Breastfeeding Journal
title Perceptions and experiences related to use of breastmilk from another mother in central Nepal: a qualitative study
title_full Perceptions and experiences related to use of breastmilk from another mother in central Nepal: a qualitative study
title_fullStr Perceptions and experiences related to use of breastmilk from another mother in central Nepal: a qualitative study
title_full_unstemmed Perceptions and experiences related to use of breastmilk from another mother in central Nepal: a qualitative study
title_short Perceptions and experiences related to use of breastmilk from another mother in central Nepal: a qualitative study
title_sort perceptions and experiences related to use of breastmilk from another mother in central nepal a qualitative study
url https://doi.org/10.1186/s13006-025-00706-8
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